
Ochsner Clinic Foundation d/b/a Ochsner Health System Annual Financial Information Disclosure For the Year Ended December 31, 2018 System Overview Ochsner Clinic Foundation d/b/a Ochsner Health System (“OCF” or “Ochsner”) is a Louisiana-based nonprofit corporation and an organization exempt from taxation under Section 501(c)(3) of the Internal Revenue Code (the “Code”) founded on providing the best patient care, research and education. Ochsner is the largest non-profit, academic, multi-specialty, integrated healthcare delivery system in the Gulf Coast region with nine hospitals, 87 health centers, 15 Urgent Care Clinics and four Occupational Health Clinics. When combined with affiliated hospitals, Ochsner owns, provides management assistance and support, or is affiliated with 31 hospitals. It also employs approximately 1,500 active staff physicians that have 1,300 board certifications in 78 specialties, trains 288 medical residents and fellows annually, has 465 Doctor of Medicine students enrolled in the University of Queensland, Ochsner Clinical School, and is currently conducting over 1,200 clinical research studies. In 2018, more than 811,000 people from all 50 states and more than 70 countries visited Ochsner. Ochsner is recognized nationally for quality. Awards and recognitions in 2018 include: Ochsner Medical Center, Ochsner Baptist, a campus of Ochsner Medical Center, and Ochsner Medical Center – West Bank Campus were ranked among the best hospitals in the country in three medical specialties, according to U.S. News and World Report’s 2018-19 Best Hospitals rankings. Ochsner Medical Center, Ochsner Baptist and Ochsner Medical Center – West Bank Campus were also ranked #1 among the best hospitals in Louisiana and #1 among the best hospitals in the New Orleans metro area as well as being recognized among the Best Hospitals in Southeastern Louisiana. Ochsner Medical Center, Ochsner Baptist and Ochsner Medical Center – West Bank Campus have received the 2018 Distinguished Hospital Award for Clinical Excellence™ from Healthgrades. Ochsner Medical Center, Ochsner Baptist, Ochsner Medical Center – West Bank Campus, Ochsner Medical Center Kenner, Ochsner Medical Center – Baton Rouge and Leonard J. Chabert Medical Center have been recognized for Five-star ratings, Specialty Excellence Awards and are among the top 5 and 10% in the nation by the Healthgrades 2018 Report to the Nation. Ochsner Medical Center was named to the IBM Watson Health’s 100 Top Hospitals® award list, formerly known as the Truven Health Analytics® 100 Top Hospitals, as one of the top U.S. Major Teaching Hospitals. Ochsner Medical Center - Baton Rouge was named as one of the top Medium Community Hospitals for the 2018 100 Top Hospitals® Award by IBM Watson Health, formerly known as the Truven Health Analytics. Becker's Hospital Review recognized Ochsner Medical Center as one of the “100 Great Hospitals in America” for 2018. This is the seventh consecutive year that Ochsner Medical has been recognized with this award and is the only Louisiana hospital named to this list. Becker's Hospital Review recognized Ochsner Medical Center-Baton Rouge as one of the “100 Great Community Hospitals in America” for 2018. Ochsner Hospital for Children was ranked among the top 50 children’s hospitals in the country for pediatric gastroenterology and gastrointestinal surgery specialties in the new 2018-19 U.S. News and World Reports Best Children’s Hospitals rankings. Eleven Ochsner Facilities or affiliated hospitals received an “A’ Grade for Patient Safety from the 2018 Leapfrog Group. 2 The following map indicates the locations of Ochsner’s acute care hospitals and health centers. See “Health Care Operations of the Credit Group – Facilities” herein for more information regarding Ochsner’s health care facilities. Ochsner Clinic Foundation Hospitals Ochsner Medical Center (1) Ochsner Medical Center Kenner (2) Ochsner St. Anne General Hospital (3) Ochsner Medical Center Northshore (4) Ochsner Medical Center Baton Rouge (5) Ochsner Medical Center West Bank (6) Ochsner Baptist Medical Center (7) Ochsner Elmwood Hospital (8) Ochsner Hancock Medical Center (9) Ochsner Clinic Foundation Affiliate Hospitals St. Charles Parish Hospital (10) Terrebonne General Medical Center (11) Leonard J. Chabert Medical Center (12) Slidell Memorial Hospital (13) St. Tammany Parish Hospital (14) St. Bernard Parish Hospital (15) * Ochsner-LSU Health’s two hospitals in Shreveport and Monroe, Lafayette General Health’s seven hospitals, CHRISTUS Health Louisiana’s seven hospitals (incl. CHRISTUS Ochsner St Patrick Hospital and CHRISTUS Ochsner Lake Area Hospital) are excluded from map as each is located outside of the Service Area as hereinafter defined. 3 Forward-Looking Information: This Financial Information Disclosure contains disclosures, which contain “forward-looking statements” within the meaning of the Federal securities laws. Forward-looking statements include all statements that do not relate solely to historical or current fact and can be identified by the use of words “expect”, “anticipate”, “intend”, “project”, “likely”, “may”, “might”, “estimate”, “budget” and similar words or expressions. These forward-looking statements are based on the current plans and expectations of Ochsner Clinic Foundation d/b/a Ochsner Health System (“OCF” or “Ochsner”) as of the date of this report and are subject to a number of known and unknown risks and uncertainties inherent in the operation of health care facilities, many of which are beyond OCF's control, that could significantly affect current plans and expectations and OCF's future financial position and results of operations. Important factors that could cause results to differ materially from those expected by management include, but are not limited to, general, economic and business, competition from other healthcare facilities in the service areas, an unfavorable pricing environment, inability to achieve expected efficiencies in operations or effectively control health care costs, the efforts of insurers and others to contain health care costs, changes in Medicare or Medicaid reimbursement formulas, the risk that managed care provider arrangements will not be negotiated or renewed on acceptable terms, future divestitures or acquisitions which may have a financial impact, availability and terms of capital to fund future expansion and ongoing capital needs, new laws or regulations, the possible enactment of federal or state health care reform, fines or penalties related to regulatory matters, changes in accounting standards and practices, the outcome of pending and future litigation and government investigations, labor issues and the ability to attract and retain qualified management and other personnel, including physicians, nurses and medical support personnel. Given these uncertainties, bondholders and prospective bondholders are cautioned not to unduly rely on such forward-looking statements when evaluating the information presented in this report. OCF disclaims any obligation, and makes no promise, to update any such factors or forward-looking statements or to disclose any facts, events or circumstances after the date hereof that may affect the accuracy of any forward-looking statements, whether as a result of changes in underlying factors, to reflect new information, as a result of the occurrence of events or developments or otherwise. 4 Description of Credit Group Ochsner’s history began when the Ochsner Clinic opened its doors to patients on January 2, 1942 as a physician practice. Alton Ochsner Medical Foundation (“AOMF”), a Louisiana not for profit corporation exempt from taxation under Section 501(c)(3) of the IRS Code, was founded on January 21, 1944 to own and operate Ochsner Foundation Hospital. On August 31, 2001, Ochsner Clinic merged with a wholly-owned subsidiary of AOMF and Ochsner Clinic became a wholly-owned subsidiary of AOMF. As part of the acquisition of Ochsner Clinic, AOMF changed its name to Ochsner Clinic Foundation (“OCF”). Ochsner Community Hospitals (“OCH”) and Ochsner Health System (“OHS”), each a Louisiana not for profit corporation exempt from taxation under Section 501(c)(3) of the IRS code, were formed in July 2006. OCH was formed for the purpose of acquiring certain medical facilities from Tenet Healthcare Corporation, and OHS was formed to be the parent company and sole corporate member of OCF and OCH. Effective December 31, 2016, OCH was merged with and into OCF, with OCF continuing as the surviving entity. Effective December 31, 2017, OHS was merged with and into OCF, with OCF continuing as the surviving entity. Ochsner Clinic Foundation still operates under the trade name of Ochsner Health System. All references to “Ochsner,” “Ochsner Health System,” “OCF,” or “OHS” hereinafter refer to Ochsner Clinic Foundation. OCF is the only Obligated Group Member under the Master Indenture. Certain affiliates of OCF have been designated as Designated Affiliates and Credit Group Members under the Master Indenture. Credit Group or Credit Group Members means all Obligated Group Members and Designated Affiliates. Under the Master Indenture, Obligated Group Members are jointly and severally liable to make payments with respect to Obligations issued under the Master Indenture. Designated Affiliates are not obligated to make payments with respect to Obligations but may be required to transfer to Obligated Group Members, to the extent legally available, amounts necessary to enable the Obligated Group Members to make
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